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. 2018 Feb 6;4(4):FSO286.
doi: 10.4155/fsoa-2017-0129. eCollection 2018 Apr.

Use of biomedical photonics in gynecological surgery: a uterine transplantation model

Srdjan Saso  1   1 , Neil T Clancy  2   3   2   3 , Benjamin P Jones  4   4 , Timothy Bracewell-Milnes  5   5 , Maya Al-Memar  4   4 , Eleanor M Cannon  4   4 , Simran Ahluwalia  6   6 , Joseph Yazbek  6   6 , Meen-Yau Thum  7   7 , Tom Bourne  8   8 , Daniel S Elson  3   9   3   9 , James Richard Smith  10   10 , Sadaf Ghaem-Maghami  11   11
Affiliations

Use of biomedical photonics in gynecological surgery: a uterine transplantation model

Srdjan Saso et al. Future Sci OA. .

Abstract

Aim: Uterine transplantation (UTx) has been proposed as a treatment for permanent absolute uterine factor infertility. The study aims were to compare pulse oximetry and multispectral imaging (MSI), for intraoperative tracking of uterine oxygen saturation in animal UTx models (rabbit and sheep).

Results/methodology: Imaging results confirmed the re-establishment of adequate perfusion in the transplanted organ after surgery. Comparison of oxygen saturation values between the pre-UTx donor and post-UTx recipient, and pre-UTx and post-UTx recipient reveals a statistically significant decrease in saturation levels post-UTx.

Conclusion: The use of MSI is the first case in gynecology and has demonstrated promise of possible future human use. MSI technique has advantages over pulse oximetry - it provides spatial information in a real-time, noncontact manner.

Keywords: optical imaging; oxygen saturation; surgical imaging; tissue perfusion; uterine transplantation.

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Conflict of interest statement

Financial & competing interests disclosure T Bourne is supported by the NIHR Biomedical Research Center based at Imperial College National Health Service Healthcare Trust and Imperial College London. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed. No writing assistance was utilized in the production of this manuscript.

Figures

<b>Figure 1.</b>
Figure 1.. Modified finger probe to allow wider opening of the jaws to fit satisfactorily around the uterine cornua.
<b>Figure 2.</b>
Figure 2.. Multispectral imaging laparoscope.
(A) Multispectral imaging laparoscope with Xenon light source and control computer; (B) multispectral imaging laparoscope in action over the operative field.
<b>Figure 3.</b>
Figure 3.. Hyperspectral laparoscopic system consisting in a charged-coupled device camera and a liquid crystal tuneable filter attached to a regular rigid laparoscope.
<b>Figure 4.</b>
Figure 4.. Variation in oxygen saturation and perfusion index values when measured with a pulse oximeter and a multispectral imaging laparoscope (rabbit model).
(A) Oxygen saturation values of the donor and the recipient rabbit measured with a pulse oximeter; (B) Perfusion index values of the donor and the recipient rabbit measured with a pulse oximeter (C); Oxygen saturation values of the donor and the recipient rabbit measured with a multispectral imaging laparoscope. ET: Embryo transfer; UTx: Uterine transplantation.
<b>Figure 5.</b>
Figure 5.. Uterine transplantation #5.
The images on the left are standard images of the rabbit cornua produced using a red green blue filter. The images on the right are reference tissue O2Sat images. The O2Sat images are displayed using a color scale that ranges from ‘0’ (dark blue) to ‘1’ (bright red). UTx: Uterine transplantation.
<b>Figure 6.</b>
Figure 6.. Images taken on day 89 post uterine transplantation (#5) just prior to embryo transfer.
UTx: Uterine transplantation.
<b>Figure 7.</b>
Figure 7.. Variation in oxygen saturation and perfusion index values when measured with a pulse oximeter and a multispectral imaging laparoscope (sheep model).
(A) Oxygen saturation values pre- and post-autotransplant measured with a pulse oximeter; (B) Perfusion index values pre- and post-autotransplant measured with a pulse oximeter; (C) Oxygen saturation values pre- and post-autotransplant measured with a multispectral imaging laparoscope. UTx: Uterine transplantation.
<b>Figure 8.</b>
Figure 8.. Images correspond to uterine transplantation #5.
The images on the left are standard images of the sheep cornua produced using a red green blue filter. The images on the right are reference tissue oxygen saturation images. The oxygen saturation images are displayed using a color scale that ranges from ‘0’ (dark blue) to ‘1’ (bright red). UTx: Uterine transplantation.
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